Levy Antonin, Rusthoven Chad G, Brown Paul D, Le Péchoux Cécile, Faivre-Finn Corinne
Department of Radiation Oncology, Gustave Roussy, Université Paris Saclay, Villejuif, France; Gustave Roussy, Inserm U1030, Radiothérapie Moléculaire et Innovations Thérapeutiques, Université Paris Saclay, Villejuif, France; Faculté de Médecine, Université Paris Saclay, Le Kremlin-Bicêtre, France.
Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado.
J Thorac Oncol. 2025 Mar;20(3):395-398. doi: 10.1016/j.jtho.2024.11.011. Epub 2024 Nov 15.
Prophylactic cranial irradiation (PCI) has long been used for SCLC to reduce the risk of brain metastases and potentially improve overall survival. Nevertheless, recent immunotherapy trials have provided limited data on its impact, as few patients were treated with PCI. The ADRIATIC trial reported improved outcomes with consolidation immunotherapy in limited-stage SCLC, and PCI was a stratification factor. Notably, patients receiving PCI in both arms had better outcomes than those who did not. Ongoing studies, such as EORTC-1901 PRIMALung (NCT04790253) and SWOG 1827-MAVERICK (NCT04155034), are further investigating PCI's role in the era of immunotherapy, highlighting its potential importance in evolving treatment strategies.
预防性颅脑照射（PCI）长期以来一直用于小细胞肺癌（SCLC），以降低脑转移风险并可能提高总生存率。然而，最近的免疫治疗试验提供的关于其影响的数据有限，因为接受PCI治疗的患者很少。ADRIATIC试验报告了局限期SCLC巩固免疫治疗的疗效改善，且PCI是一个分层因素。值得注意的是，双臂接受PCI的患者比未接受PCI的患者预后更好。正在进行的研究，如欧洲癌症研究与治疗组织（EORTC）-1901 PRIMALung（NCT04790253）和美国西南肿瘤协作组（SWOG）1827-MAVERICK（NCT04155034），正在进一步研究PCI在免疫治疗时代的作用，凸显了其在不断演变的治疗策略中的潜在重要性。
